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Bowel Incontinence—also referred to as fecal incontinence—is the inability to control the passage of liquid or solid stool from the rectum. Bowel incontinence can be present at any age and is found to be more common in the elderly population. Like urinary incontinence, bowel incontinence is not a normal part of aging. People with bowel incontinence often feel embarrassed and uncomfortable discussing with their healthcare provider. They often feel there is no assistance or treatment available to help with their problem. Bowel incontinence often can be related to underlying medical conditions and treatment options are available.
Injury of the nervous system. Causes of bowel incontinence can be a result of an injury of the nervous system, such as spinal cord injury or spina bifida, and diseases such as Multiple Sclerosis, Parkinson’s and Stroke, which cause nerve damage.
- Pressure on the pelvic floor. Women who have experienced vaginal childbirth may experience bowel incontinence due to the pressure placed on the pelvic floor during pregnancy and childbirth. Often this does not present itself until later in a woman’s life, when she starts to lose muscle tone with the normal process of aging. The organs of the pelvic floor then lose their elasticity and capability to compensate for the injury and incontinence is the end result.
- Chronic constipation. With chronic constipation, stool will build up, becoming hard and lead to difficulty having a bowel movement. In severe cases the stool cannot be passed and there is a risk for bowel impaction. This occurs when the stool has hardened and formed in the rectum. Diarrhea or loose stool can be present when the stool has become hard or impacted, and watery liquid may begin to leak from the rectum. Diarrhea incontinence can also result from loose stool forming in the rectum quickly, not allowing for enough time to make it to the restroom.
- Anal sphincter dysfunction. Men and women both can experience anal sphincter dysfunction, which is a common cause of bowel incontinence. This can result from a normal weakening of the anal sphincter muscle related to aging, leading to uncontrollable release of stool.
- Others. Other causes of bowel incontinence are anal surgery, certain medications, improper diet and unhealthy lifestyle.
Treatment of Bowel Incontinence with Lifestyle Changes
Maintaining a healthy lifestyle including regular exercise and healthy diet are pertinent to bowel health. Treatment for bowel incontinence can be as simple as making lifestyle adjustments. Daily diet should include a variety of fresh fruits, vegetables and whole grains ensuring adequate fiber intake. Proper fluid intake should be accomplished with water or non-caffeinated beverages. When the urge to have a bowel movement occurs use the restroom. Continuous holding of bowel movement will cause hardening of stool, leading to difficulty with elimination. Regular exercise incorporating Kegel exercises along with maintaining adequate fiber and fluid intake can promote bowel health and regular bowel movements. Your healthcare provider may suggest absorbent incontinent products such as Prevail®, fecal incontinence collection systems, sacral nerve stimulation and injectable bulking agents. Skin products may be recommended to reduce skin irritation, breakdown or infection.
Talking to Your Healthcare Provider
While Bowel incontinence can be embarrassing to discuss, know that assistance and treatment options are available to help live a normal and healthy lifestyle. If you experience bowel incontinence, first discuss with your healthcare provider. Keep a bowel diary to document bowel movements and incontinence episodes. Bring this to the visit with your healthcare provider. It will be helpful to have a list of your medications, medical history, childbirth history, surgeries and any other medical problems you may be experiencing. They may be able to make medication adjustments that will help with bowel incontinence. Being prepared for your visit will be beneficial to you and your provider, allowing them to schedule any testing or procedures to identify and start a plan of care for your bowel incontinence.
Sources: NAFC, National Institute of Diabetes and Digestive and Kidney Disease, American Society of Colon and Rectal Surgeons